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NPI Code Detail

MEDICARE: MS. PENNY LYN GADZINI M.DIV.

MEDICARE:  MS. PENNY LYN GADZINI  M.DIV.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor002769NY

General Provider Information

NPI Number : 1891903076
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PENNY LYN GADZINI M.DIV.
Provider Business Mailing Address
First Line : 65 E MALTBIE AVE
Second Line :
City : SUFFERN
State : NY
Zip : 10901-6007
Country : US
Telephone Number : 917-287-0583
Fax Number :
Provider Business Practice Location Address
First Line : 37 E ALLENDALE AVE
Second Line :
City : ALLENDALE
State : NJ
Zip : 07401-2095
Country : US
Telephone Number : 201-327-2424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2007
Last Update Date : 07/08/2007

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Directions to “ MS. PENNY LYN GADZINI M.DIV.” Practice Location

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